'Excessive' Calories in Popular Restaurant Chain Main Dishes

Theresa Bebbington

December 13, 2018

Two studies published in The BMJ on 12th December have looked at the calorie content of popular main meal dishes served by restaurant chains. One study concentrated on the UK and the other study looked at five other countries and compared them to US data.

Dining out has become popular in many developed countries, and in the UK a 2016 report from the UK Food Standards Agency found 39% of UK adults ate out at least once a week. However, some studies have found that people who eat out more frequently are at a greater risk of weight gain and obesity. Previous studies have looked at the poor nutritional content of fast food, but the energy content of traditional 'full service' restaurant meals has been mostly neglected.

In two separate observational studies, researchers compared the calorie content of popular meals from major fast food and full service restaurant chains to better understand the extent that restaurants may be contributing to overeating. As a guideline, Public Health England (PHE) recommended in September 2018 that lunch and evening meals contain about 600 kcal each.

UK-based Study

Researchers at the University of Liverpool noted that studies of North American dining had found excessive calories in main meal dishes from restaurant chains, and they speculated that the negative publicity of the poor nutritional value of fast food has had an impact on fast food options.

For their study, the researchers included restaurant chains that had 50 or more outlets and provided nutritional information. They analysed the calories in 13,396 main meals provided by 27 UK restaurant chains; 21 of these were full service restaurants and the remaining six were fast food chains. They did not include coffee shops or chains that provide only takeaway food. Fast food chains were considered as primarily providing largely pre-prepared quick meals with little or no table service, with in-store seating, or takeaway orders. The researchers looked at only the 'main course' element of a menu; starters, side dishes, drinks, and desserts were not included. They found:

  • On average, main meal dishes from full service restaurant chains contained 1033 kcal

  • On average, main meal dishes from fast food chains contained 751 kcal

  • Only 9% of meals met PHE's recommendation of 600 kcal or less

Excessive Calories in the UK

There is a lack of international consensus on what quantifies as "excessive" kilocalories in a meal. The researchers defined it for the purposes of their study as "main meals that had 1000 kcal or more, as in a single course this would constitute 50% and 40% of the recommended total number of daily kilocalories for women and men respectively". The research showed that 47% of total meals contained 1000 kcal or more, which would put them in the researchers' excessive category.

The results show that, on average, full service restaurants in the UK provide main meals with higher kilocalories than fast food chains. The researchers could not provide reasons for main meals from full service restaurants being higher in energy than those from fast food chains but explain multiple factors could be involved, including the type of food, portion sizes, and cooking methods.

Medscape News UK asked lead author Eric Robinson about any trends in the types of food served being higher or lower in calories. He told us: "As you might imagine some food types are more calorific than others. In the UK, pies and other traditional 'pub' food style dishes were often particularly high in kcals. We also observed a lot of variability, eg. you'd presume that salads would be universally low in kcals, but the kcal content of salad meals ranged across restaurants and some were not low in kcals. More generally, only 9% of meals met public health guidelines for meal kcal content and this leaves customers with very few options even if they do want to be calorie conscious."
 

Multi-Country Study

In the second study, an international research team led by researchers at Tufts University in Boston, Massachusetts, USA, measured calories in popular meals ordered from 111 randomly selected full service and fast food restaurants in five countries: Brazil, China, Finland, Ghana, and India. They also included 10 meals from five worksite canteens in Finland for their study and compared the results to data on popular meal choices from US restaurants. A total of 233 meals were analysed. In this study, side dishes that came with a main course at no extra charge were included in the analysis. Starters, drinks, and desserts were omitted. 

The researchers found that the total kilocalories of fast food menus were significantly lower than that of meals from full service restaurants in Brazil, China, and the US. Only China served meals containing significantly less kilocalories than US full service restaurants and less than US fast food chains. The study also found that contrary to popular perception, fast food meals contained on average 33% fewer kilocalories than full service restaurants.
 

Similar Findings

The two studies had similar results. The UK-based study reported on average 1033 kcal in main meal dishes from full service restaurants and 751 kcal from fast food chains, while the multi-country study reported 1317 kcal and 809 kcal respectively. Both studies reported the majority of midday and evening meals being well above the recommended 600 kcal per meal.

Reacting to the findings, Louis Levy, head of nutrition science at PHE, told Medscape News UK: "With eating out now the norm, consumers want healthier food with less sugar and calories. From cafes to the big high street chains, everyone has a role to help combat obesity."

The BMJ.  2018;363:k4982. Paper.
The BMJ.  2018;363:k4864. Paper

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